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No. 44: Suicide Ideation

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No. 44 Suicide Ideation

Suicide ideation is the abstract thought of ending your life or believing that other people may be better off without you.  It is important to remember that a person expressing suicide ideation does not necessarily go on to complete suicide.
If you believe a person to be in immediate danger and/or someone has hurt themselves and you think their injuries are life-threatening, call an ambulance on 999. You can do this whether you are with them in person or not. You will need to be able to give a location.

Why do young people experience suicide ideation?

It is quite natural for young people to become stressed or anxious about things such as exams or moving school. However there may be significant risk factors that present themselves or that a young person has experienced in the past which may trigger suicide ideation.

  • Previous self-harm, suicidal thoughts or suicide attempt
  • Substance use
  • Evidence of mental health problems, especially depression, psychosis, post-traumatic stress disorder or eating disorder
  • History of experiencing physical, emotional or sexual abuse
  • Loss or bereavement – could include loss of relationships or social status (anniversaries can be significant)
  • Pressure on social media
  • Family factors – instability (divorce, separation, changes of care giver, repeated house moves), conflict, arguments, domestic violence
  • Family history of suicide, mental illness or substance misuse
  • Issues of gender or sexual orientation
  • Children and young people who may have been radicalised
  • Bullying

What are the possible signs of suicide ideation?

Signs of depression in children and teenagers can include:

  • persistent low-mood or lack of motivation
  • not enjoying things they used to like doing
  • becoming withdrawn and spending less time with friends and family
  • experiencing low self-esteem or feeling like they are ‘worthless’
  • feeling tearful or upset regularly
  • changes in eating or sleeping habits.

Signs of anxiety in children and teenagers can include:

  • becoming socially withdrawn and avoiding spending times with friends or family
  • feeling nervous or ‘on edge’ a lot of the time
  • suffering panic attacks
  • feeling tearful, upset or angry
  • trouble sleeping and changes in eating habits.

What you might hear:

  • ‘I can’t take it any more’
  • ‘Nobody cares about me’
  • ‘I can’t see the point any more’
  • ‘Everyone would be better off if I weren’t here’
  • ‘Nothing matters any more’
  • ‘I’m going to top myself’

How can you support someone experiencing suicide ideation?

It is important not to describe the young person’s thoughts as:

  • selfish
  • stupid
  • cowardly or weak
  • a choice
  • a sin (for example, tell that person he/she is going to hell)

 
Instead start up a conversation. You are not putting that person at greater risk by asking if they want to talk about their worries. In fact a short conversation could be the difference between life and death. (Take a look at #smalltalksaveslives video, link at end of OMG.)

How to start a conversation?

Could you use the following to help start a conversation?

  • “I’ve noticed that you haven’t been yourself lately, is everything ok with you?”
  • “I’m worried about you. I’m wondering if we can talk about what’s troubling you?”
  •  “You’ve seemed really (down/sad/angry/unhappy) lately. I’m worried that you might be thinking of hurting yourself or suicide. Can we talk about this?”

 
As with any safeguarding disclosure you cannot promise secrecy.  It might be that the young person you have concerns about does not want to talk with you, always consider who that young persons trusted adult might be and involve them whenever possible.
Make sure that you listen to the young person and use all the communication skills you would when receiving a disclosure.  Maintain eye contact, do not make judgements, minimise or judge their situation etc.
During the conversation if the young person gives the impression that they are serious in taking their own life it is important that you seek professional advice and support immediately.  There are links to organisations that can provide support at the end of this document.  You may also want to create a safety plan for the young person.  If you feel the risk is low work with the young person to identify the support they need and the people around them that could help e.g. parents, class teacher, and football coach.

W.A.I.T

‘WAIT’ is one good way to remember how you can support another person who may be suicidal. WAIT stands for:

  •  W – Watch out for signs of distress and uncharacteristic behaviour
    e.g. social withdrawal, excessive quietness, irritability, uncharacteristic outburst, talking about death or suicide
  • A – Ask “are you having suicidal thoughts?”. Asking about suicide does not encourage it, nor does it lead a person to start thinking about it; in fact it may help prevent it, and can start a potentially life-saving conversation
  • I – It will pass; assure them that, with help, their suicidal feelings will pass with time
  • T – Talk to others – encourage them to seek help from a GP or health professional

Myths and facts about suicide

Myth: People who talk about suicide won’t really do it
Fact: Almost everyone who attempts suicide has given some clue or warning. Don’t ignore even indirect references to death or suicide. Statements like “You’ll be sorry when I’m gone,” “I can’t see any way out,”—no matter how casually or jokingly said—may indicate serious suicidal feelings.
Myth: Anyone who tries to kill him/herself must be crazy.
Fact: Most suicidal people are not psychotic or insane. They are upset, grief-stricken, depressed or despairing, but extreme distress and emotional pain are not necessarily signs of mental illness.
Myth: If a person is determined to kill him/herself, nothing is going to stop them.
Fact: Even the most severely depressed person has mixed feelings about death, wavering until the very last moment between wanting to live and wanting to die. Most suicidal people do not want death; they want the pain to stop. The impulse to end it all, however overpowering, does not last forever.
Myth: People who die by suicide are people who were unwilling to seek help.
Fact: Studies of suicide victims have shown that more than half had sought medical help in the six months prior to their deaths.
Myth: Talking about suicide may give someone the idea.
Fact: You don’t give a suicidal person morbid ideas by talking about suicide. The opposite is true—bringing up the subject of suicide and discussing it openly is one of the most helpful things you can do.

The information contained in this OMG has been gathered from a number of sources – links for these are provided below.  The links can provide further information for professionals, young people and their parents/families.  They also run courses if you want to know more about how to support young people and their mental health.
Statistics:
Suicides in England and Wales – Office for National Statistics (ons.gov.uk)
World Health Organisation: Do you know someone who may be considering suicide? (leaflet)

DSCP: Suicide awareness: Information for professionals
NHS: for tips on how to start a conversation, creating a safety plan, helpline support
NHS help for suicidal thoughts
#smalltalksaveslives – Small talk saves lives (video)
Young Minds support for young people, parents and professionals
Childline website for further advice and link to ‘chat’ support function
Torbay Safeguarding Hub: links to CYPMHS South Devon and Torbay and signposting to other organisation’s in the locality.
NSPCC: Depression, anxiety, mental health
Papyrus: Suicide Prevention Charity
Children and Young People’s Mental Health Services (formally CAMHS)


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